Abstract: Because other cultures classify mental
disorders very differently from ours, it behooves us to inquire
into the philosophical and cultural sources of our own guiding
nosological categories. This paper is a philosophical exploration
into the historical and theoretical bases of the late
nineteenth-century, Kraepelinian division between disorders of mood
or affect, and schizophrenia, in which our present day nosological
categories are rooted. By tracing the early nosologists' divisions
into eighteenth-century and Kantian faculty psychology, and
following the fate of faculty psychology through the nineteenth
century, we discover genealogical elements of our taxonomy likely
to affect clinical diagnosis and understanding.

Introduction

Influenced by the great psychiatric classifiers of the past,
Western twentieth-century nosological maps reveal a notable
division among the severe conditions known as disorders (DSM), or
psychoses (ICD). The forms of dysfunction associated with mood or
affect are separated from those associated with schizophrenia. We
may suppose we understand why this is so. Yet many psychological
concepts, we know, are a reflection of culture. And it is not only
that other cultures mark aspects of the self, personality,
disposition and behavior in terms and categories distinguishable
from ours, and adhere to contrary mental health norms. In addition,
the very broadest categories and divisions by which different
mental disorders are classified are in other cultures and
traditions radically different from ours, as a recent survey (1990)
by Wig has illustrated. Based upon an analysis of medical
classifications in Asian, African and Islamic traditions, Wig
concludes of the current division of psychoses separating mood or
affective disorder from schizophrenia that "such concepts do not
find a recognition in traditional Third World classifications"
(195, my emphasis).

Perhaps not a great deal need be made of this. Any one of
several possibilities would permit us to avoid the conclusion that
our Western division is arbitrary, misleading, or unacceptably
culture-bound. Other taxonomies might be wrong, inaccurate, or
based on bad science. Or they may be culture-relative: intelligible
within the guiding conceptual schemas of the settings which have
given rise to them, but "untranslatable." Finally, other taxonomies
might be a reflection of cultural variation in epidemiology. Yet
whatever they are taken to mean, such findings as Wig's disturb;
they seem to invite at least an exploration into the historical and
theoretical bases for the late nineteenth-century classification in
which our present day division is rooted. They alert us to the
possibility of historical contingencies which might mean our
taxonomy is less than universally applicable, arbitrary, or worse,
reflective of some ideological or normative bias.

That is the impetus for the present paper. We need to trace
these divisions to their source in the theories of faculty
psychology from the eighteenth century in Europe and America,
through whose lens early classifiers such as Kraepelin saw the
world. Doing so, we shall discover how the separation of affection
from cognition looks to be Eurocentric, as Wig's findings suggest,
rather than a natural division, and "modernist," a creation of
seventeenth- and eighteenth-century thinking. And we shall see how
recognition of this feature of the division was obscured -- on the
one hand by its transparent familiarity, and on the other by its
complex emergence through and relation to faculty psychology, whose
own dubious association with phrenology in the nineteenth century
led to faculty psychology's ostensible demise.

Diseases of the Intellect and Diseases of the Passions

In the literature on psychiatric classification, classifiers
themselves have come to be classified. There are "splitters" who
elaborate the differences between disorders and symptom clusters,
and "lumpers," who stress the similarities. (Whether these types --
splitters and lumpers -- reflect styles or fashions of
classification linked to a particular era, rather than personal
idiosyncracy, is an interesting question, but not one explored
here.) Kraepelin was a lumper par excellence, and his lumps are
reflected in the broad division between manic-depressive disease
and dementia praecox. Earlier divisions and "splittings"
were brought together by Kraepelin in two categories of psychosis,
one for mental disease primarily affecting mood or affect, another
for dysfunction or disease primarily affecting...

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